Document Detail


A trigger tool fails to identify serious errors and adverse events in pediatric otolaryngology.
MedLine Citation:
PMID:  20869555     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify and quantify errors and adverse events on an inpatient academic tertiary-care pediatric otolaryngology service, a trigger tool was developed and validated as part of a quality improvement initiative. STUDY DESIGN: Retrospective record review. SETTING: Children's Hospital Boston quality improvement initiative. SUBJECTS AND METHODS: Fifty inpatient admissions were reviewed. The gold standard for errors and adverse events identification was a detailed chart review by two board-certified otolaryngologists blinded to trigger tool findings. RESULTS: Trigger tool interrater reliability ranged from poor to high for admission triggers (kappa = 0.35, 95% confidence interval [95% CI] -0.07 to 0.76), discharge triggers (kappa = 0.63, 95% CI 0.27-0.99), medical records triggers (kappa = 0.61, 95% CI 0.11-1.00), and medication triggers (kappa = 0.90, 95% CI 0.71-1.00). Errors and adverse events were found in all admissions: three percent were potentially harmful, and 93 percent were documentation-related. CONCLUSION: The trigger tool was successful in identifying clerical and administrative errors and adverse events but failed to identify complex errors and adverse events. A hybrid approach for chart review may be cost-effective in pediatric otolaryngology.
Authors:
Lina Lander; David W Roberson; Katrina M Plummer; Peter W Forbes; Gerald B Healy; Rahul K Shah
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery     Volume:  143     ISSN:  1097-6817     ISO Abbreviation:  Otolaryngol Head Neck Surg     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-27     Completed Date:  2010-11-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508176     Medline TA:  Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  480-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American Academy of Otolaryngology–Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA. llander@unmc.edu
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MeSH Terms
Descriptor/Qualifier:
Child
Humans
Medical Errors*
Medical Records
Medication Errors
Observer Variation
Otolaryngology
Otorhinolaryngologic Surgical Procedures*
Patient Admission
Patient Discharge
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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